Scheduling is at the heart of healthcare. Poor, or even mediocre, scheduling processes can cost a small clinic hundreds of thousands of dollars. Creating and using meaningful appointment types to optimize scheduling for your practice is important for the bottom line and decreasing stress and burnout. This is a challenge for any practice.
First and foremost, the scheduling system needs to integrate all facets of care. The goal is to simultaneously optimize patient care, the patient experience, the provider experience, and finances. Anything less than this is unacceptable.
The schedule needs to integrate all individuals and departments involved in a patient visit, the visit is inpatient, outpatient, testing, or clinical evaluation. The system is interconnected like a neural network and needs to be directed like one. The schedule must account for each aspect of the encounter to ensure a truly optimized system.
The appointment types in the system needs to organize all these issues. Numerous issues and questions swirl around the appointment type. The way appointment types are must make logical sense to the veteran and new user alike. The number of appointment types must be manageable. How can like procedures be lumped into a single appointment type while maintaining the individuality of that specific procedure or appointment?
In order to create the appointment type and the associated protocols, each appointment and procedure must be fully analyzed from initiation to completion. Each component should be listed, and associated tasks delineated. Once this has been accomplished create a matrix for all tasks associated with all appointment types. Only then can like appointments and procedures be lumped into a straightforward appointment template.
Oversimplification rivals complexity as a risk in this process. Getting this wrong cost time, reimbursement, overhead, and burnout. Get it right.
Appointment Types Matter
A smooth scheduling process and a smooth encounter can produce happy patients. Happy patients make for more pleasant visits, decreasing staff burnout. Happy patients also provide good word of mouth and online advertising. Furthermore, a smooth scheduling process decreases the opportunity for errors, improving patient care and outcome.
Make sure patients show for the appointments. Then make sure they want to come back. New patient encounters typically generate several times more revenue than a follow-up but both appointment types are important. Make sure the appointment schedule is designed to optimize patient care and the financial health of the practice at the same time. Adequate number of appointment slots for new patient visits and testing are of paramount importance.
Be certain that each patient visit is associated with the correct appointment type. Clarity and accuracy at this level improve billing accuracy. Improved coding can enhance revenue and help insulate the practice from the pitfalls of incorrect coding.
Don’t create templates without guidance. Creating optimized workflow is a team sport. Include everyone on the team–especially the individual who will perform the visit. The schedule should not be the enemy of anyone in the practice. Appropriate appointment types and the structure of a scheduling template can have dramatic effects on work-related stress and burnout.
Training new hires or adding a new protocol for existing schedulers should be straightforward, if not actually easy. Using the right technology can even eliminate mundane and repetitive tasks that drain staff morale and provide no value-added service. Spend your money on things that matter. Using optimized templates and appointment types, in concert with technological support yields an efficient service. Complicated appointment templates and too wide a variety of appointment types creates roadblocks to care and business.
Origin of Inefficient Schedules
We do it that way because that is the way its been done is a common but lousy answer.
Appointment Types Are Setup When You Know the Least
With most new systems, you need experience to be good, and this is clearly true of scheduling. Many times, the scheduling system is created and implemented when the electronic health record (EHR) system is new or when a practice is first opening. Even if a new EHR system is obtained, the old scheduling methods are moved into the new platform. Every good system needs to be monitored and updated regularly. Appointment types and templates should be reviewed at least yearly. Make sure your system evolves with you and the realities of care you deliver.
Eager to Get Going
If you are like most people, you want to just get started. Take the time to go through the steps and create what you want, what you need, and what will bear fruit. Leveraging technology can get you up to speed more quickly. But nothing can replace careful planning.
Creating and Using Meaningful Appointment Types – The Process
Identify the members of the team who are needed to build an optimized schedule. This means understanding the process from inception to completion. Get input from a responsible staff member for each step in the process–including providers, nurses, medical assistants, schedulers, and receptionists.
Schedule a meeting for building appointment types and templates at a time that does not conflict with clinical duties. Interruptions and competing interests will rob you of success.
Create a list of all appointment types. Assign homework before the meeting. Each participant should be able to provide a comprehensive accounting of the duties and time needed to complete any specific task they do. This will help you understand the problems and find the needed solutions. The process can then be streamlined, and many repetitive tasks diverted into automated systems.
Decide on the appropriate template and appointment types. Create a master catalog of the templates and their contents. Assign specific individuals to create templates and update appointment types.
Revisit and Revise
Optimization is a moving target. Plan to revisit this and all protocols on a regular basis.
Problematic Appointment Type
Improve patient flow by avoiding the common problems.
New Patient Appointments
For the small office or solo practitioner, new patient appointments are not likely to be a big problem. For the larger office or multispecialty group, these appointments can be vitally important. Different types of new appointments could easily have different visit times or potential associated testing.
Standardize the verbiage for follow-up visits. Specify the time and any special needs for that visit. Then place all the information into the schedule and store the original in the notes fields of the EHR.
For post-operative follow-up, schedule the appointment with notation of the procedure that was performed. Many post-operative visits must have pre-visit testing for the visit to be truly meaningful. Make sure these requirements are built into the system. Be mindful of special instructions and exceptions to your standard scheduling guidelines.
4. Physical Examinations and Wellness Visits
If your practice has a large volume of a certain visit type such as an annual wellness visit or a coordination-of-care visit, create appointment types with the associated guidelines for that visit and any special instructions.
Be thoughtful and methodical. Don’t skimp on the planning. Most importantly, get started. The schedule is the heart of the business of medicine and the delivery of care. We must optimize the schedule in order to make real progress optimizing the whole practice.